Surgical clip applier

ABSTRACT

A surgical clip applier is provided including a clip pusher bar having a flexible tab and a camming plate configured to effectuate closure of the pair of jaws. The camming plate includes a lost motion portion and the flexible tab is configured to engage the lost motion portion during an initial movement of the clip pusher bar to cause the camming plate to move with the clip pusher bar. The flexible tab is configured to disengage from the lost motion portion during a subsequent movement of the clip pusher bar to allow the clip pusher bar to move relative to the camming plate.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application claims the benefit of and priority to U.S. ProvisionalPatent Application No. 61/870,404, filed Aug. 27, 2013, the entiredisclosure of which is incorporated by reference herein.

BACKGROUND

1. Technical Field

The present application relates to surgical instruments, and moreparticularly, to surgical clip appliers having a plurality of clips forapplying the clips to body tissues and vessels during surgicalprocedures.

2. Discussion of Related Art

Surgical clip appliers are known in the art and have increased inpopularity among surgeons by offering an alternative to conventionalsuturing of body tissues and vessels. Typical instruments are disclosedin U.S. Pat. No. 5,030,226 to Green et al. and U.S. Pat. No. 5,431,668to Burbank, III et al. the entirety of each of which is incorporatedherein by reference. These instruments generally provide a plurality ofclips which are stored in the instrument and which are fed sequentiallyto the jaw mechanism at the distal end of the instrument upon openingand closing of the handles at the proximal end of the instrument. As thehandles are closed, the jaws close to form a clip positioned between thejaw members, and as the jaws are opened to release the formed clip, anew clip is fed from the series of clips to a position between the jaws.This process may be repeated up to and until all the clips in the seriesof clips have been used.

A need exists for clip applier having simplified operation using fewercomponents to provide a more efficient and cost effective clip applyingdevice without diminishing functionality.

SUMMARY

The present application relates to surgical clip appliers having aplurality of clips for applying the clips to body tissues and vesselsduring surgical procedures and their methods of use.

According to an aspect of the present disclosure, a surgical clipapplier is provided including a housing; at least one handle pivotablyconnected to the housing; a channel assembly extending distally from thehousing; a clip carrier disposed within the channel assembly anddefining a channel therein; a plurality of clips slidably disposedwithin the channel of the clip carrier; and a jaw assembly including apair of jaws extending from an end of the channel assembly, opposite thehousing. The jaw assembly is configured to accommodate a clip thereinand is operable to effect formation of the clip in response to movementof the at least one handle. The surgical clip applier further includes aclip pusher bar slidably supported within at least one of the housingand the channel assembly. The clip pusher bar has a first endoperatively connected to the at least one handle and at least oneflexible tab. The surgical clip applier further includes a camming plateslidably supported within the channel assembly and configured toeffectuate closure of the pair of jaws. The camming plate includes alost motion portion and the flexible tab of the clip pusher bar isconfigured to engage the lost motion portion during an initial movementof the clip pusher bar to cause the camming plate to move with the clippusher bar. The flexible tab of the clip pusher bar is configured todisengage from the lost motion portion during a subsequent movement ofthe clip pusher bar to allow the clip pusher bar to move relative to thecamming plate.

In an aspect of the present disclosure, the lost motion portion of thecamming plate includes a shoulder. The flexible tab is configured toengage the shoulder during the initial movement of the clip pusher barand to disengage from the shoulder during the subsequent movement of theclip pusher bar.

In an aspect of the present disclosure, the lost motion portion includesa first recess and a second recess. The flexible tab is slidablydisposed within the second recess during the initial movement of theclip pusher bar and is slidably disposed within the first recess duringthe subsequent movement of the clip pusher bar.

In an aspect of the present disclosure, the shoulder is located at adistal end of the second recess of the lost motion portion.

In an aspect of the present disclosure, the channel assembly includes acamming surface. The camming surface is configured to disengage theflexible tab from the lost motion portion after the initial movement ofthe clip pusher bar.

In an aspect of the present disclosure, the channel assembly includes afirst recess and a second recess. The camming surface is disposedbetween the first and second recesses of the channel assembly. Theflexible tab is configured to slide along the second recess during theinitial movement of the clip pusher bar until the camming surface isreached. The flexible tab is configured to cam along the camming surfaceto disengage the flexible tab from the lost motion portion. The flexibletab is also configured to slide along the first recess during thesubsequent movement of the clip pusher bar.

In an aspect of the present disclosure, the clip pusher bar furtherincludes a second end that is configured to urge a clip from theplurality of clips to a location between the jaws.

In an aspect of the present disclosure, the clip pusher bar is moveabletoward the jaw assembly to urge the clip from the plurality of clips tothe location between the jaws and moveable away from the jaw assembly toeffectuate closure of the pair of jaws.

In an aspect of the present disclosure, the camming plate is movableaway from the jaw assembly as the handle is actuated in a firstdirection to effectuate closure of the jaws and is movable toward thejaw assembly as the handle is actuated in a second direction toeffectuate opening of the jaws.

In an aspect of the present disclosure, the camming plate includes atleast one camming slot and the jaws include at least one camming pinreceived within the camming slot of the camming plate.

In an aspect of the present disclosure, the camming pin cams along thecamming slot to effectuate opening and closure of the jaws duringmovement of the camming plate.

In an aspect of the present disclosure, the flexible tab is distallyoriented and inwardly biased against the lost motion portion of thecamming plate.

In an aspect of the present disclosure, the camming plate includes aproximal flange and the clip pusher bar includes a distal window. Theproximal flange of the camming plate is received within the distalwindow and engagable with a distal end of the distal window when theclip pusher bar moves proximally to move the camming plate proximally.

In an aspect of the present disclosure, the clip pusher bar includes atleast one proximal window configured to receive a link member of thehandle to provide the operative connection with the handle.

According to an aspect of the present disclosure, a method of operatinga surgical clip applier is provided including the steps of actuating ahandle of a clip applier an initial amount to cause an initial movementof a clip pusher bar of the clip applier in a first direction. Aflexible tab of the clip pusher bar engages a shoulder of a cammingplate of the clip applier to cause movement of the camming plate in thefirst direction. The camming plate effectuates an opening of a pair ofjaws of the clip applier upon movement of the camming plate in the firstdirection. The method further includes actuating the handle of the clipapplier a subsequent amount to cause a subsequent movement of the clippusher bar of the clip applier in the first direction. The flexible tabdisengages from the shoulder of the camming plate such that the clippusher bar moves the subsequent amount in the first direction relativeto the camming plate.

In an aspect of the present disclosure, the method includes the step ofurging, by the clip pusher bar, a clip of a plurality of clips of theclip applier in between the jaws of the clip applier during thesubsequent movement of the clip pusher bar in the first direction.

In an aspect of the present disclosure, during the subsequent movementof the clip pusher bar in the first direction, the method furtherincludes the step of camming the flexible tab over a camming surface ofa channel assembly of the clip applier to disengage the flexible tabfrom the shoulder of the camming plate.

In an aspect of the present disclosure, the method further includes thestep of actuating the handle of a clip applier in an opposite directionto cause movement of the clip pusher bar in a second direction. The clippusher bar engages the camming plate to move the camming plate in thesection direction to effectuate a closing of the jaws.

In an aspect of the present disclosure, the method further includes thestep of moving the camming plate in the second direction due toengagement of a proximal flange of the camming plate with a distalwindow of the clip pusher bar.

In an aspect of the present disclosure, when the clip pusher bar movesin the second direction, the flexible tab of the clip pusher bar isreceived within a recess of the camming plate proximate the shoulder.The flexible tab is biased against the recess of the camming plate.

Although the above aspects and embodiments are described separately forconvenience and clarity, it is contemplated that the above aspects andembodiments may be combined without departing from the scope of thepresent disclosure.

BRIEF DESCRIPTION OF THE DRAWINGS

The present clip applier will be more fully appreciated as the samebecomes better understood from the following detailed description whenconsidered in connection with the following drawings, in which:

FIG. 1 is a top, perspective view of a surgical clip applier accordingto an embodiment of the present disclosure;

FIG. 2A is an exploded, perspective view of a handle assembly of thesurgical clip applier of FIG. 1;

FIG. 2B is a perspective view of the surgical clip applier of FIG. 1with an upper housing half of the handle assembly and a cartridge coverof a channel assembly removed;

FIG. 2C is an enlarged view of the indicated area of detail of FIG. 2B;

FIG. 3 is an exploded perspective view of a channel assembly of thesurgical clip applier of FIG. 1;

FIG. 4 is a top, perspective partial view which shows the channelassembly of the surgical clip applier of FIG. 1;

FIG. 5 is a top, perspective partial view which shows the channelassembly of FIG. 4, with the cartridge cover removed;

FIG. 6 is an exploded partial view illustrating the cartridge cover,camming plate, and clip pusher bar of the channel assembly of FIG. 4;

FIG. 7 is a partial cross-sectional view of the channel assembly of thesurgical clip applier of FIG. 1 in an initial position prior toactuation of the handles of the handle assembly;

FIG. 8 is a partial cross-sectional view of the channel assembly of thesurgical clip applier of FIG. 1 during an initial actuation of thehandles;

FIG. 9 is a partial cross-sectional view of the channel assembly of thesurgical clip applier of FIG. 1 during a subsequent actuation of thehandles; and

FIG. 10 is a partial cross-sectional view of the channel assembly of thesurgical clip applier of FIG. 1 in a final position with handles fullyactuated.

DETAILED DESCRIPTION OF EMBODIMENTS

Embodiments of surgical clip appliers in accordance with the presentdisclosure will now be described in detail with reference to the drawingfigures wherein like reference numerals identify similar or identicalstructural elements. As shown in the drawings and described throughoutthe following description, as is traditional when referring to relativepositioning on a surgical instrument, the term “proximal” refers to theend of the apparatus which is closer to the user and the term “distal”refers to the end of the apparatus which is further away from the user.

Referring now to FIGS. 1-3, a surgical clip applier in accordance withan embodiment of the present disclosure is generally designated as 100.Surgical clip applier 100 generally includes a handle assembly 102including a housing 104 having an upper housing half 104 a and lowerhousing half 104 b. Handle assembly 102 further includes a pair ofhandles 106 pivotably secured to housing 104 and extending outwardlytherefrom. A channel assembly 108 is fixedly secured to housing 104 andextends distally therefrom, terminating in a jaw assembly 110 supportedin a distal end of channel assembly 108. As seen in FIGS. 1 and 2A-2C,housing halves 104 a and 104 b of clip applier 100 fit together by,e.g., snap fit engagement with one another. Alternatively, housinghalves 104 a and 104 b may be joined through any manner including, forexample, one or more screws, fasteners and the like, through the use ofglues, or other adhesives, or through the use of plastic orradiofrequency welding.

As can be seen in FIGS. 1 and 2A-2C, handles 106 are secured to housing104 by handle pivot pins 104 d extending between lower housing half 104b and upper housing half 104 a through respective apertures 106 a formedin handles 106. Handle assembly 102 includes a link member 112 pivotallyconnected to each handle 106 at a pivot point 114 formed in a respectivehandle 106. A proximal end 112 a of each link member 112 includes ahooked or G-shaped portion 112 b that is pivotally connected to clippusher bar 160. In use, as will be described in greater detail below, ashandles 106 are squeezed, link members 112 push pusher bar 160proximally.

Referring now to FIGS. 1, 2B-2C, and 3, channel assembly 108 includes achannel or cartridge cover 130 and an outer or lower channel 132 eachhaving a proximal end retained in housing assembly 102, between upperand lower housing halves 104 a, 104 b.

Clip applier 100 further includes a clip pusher bar 160 that isreciprocally supported in and extends between handle assembly 102 andchannel assembly 108. A proximal portion of pusher bar 160 is supportedbetween upper and lower housing halves 104 a, 104 b of housing 104 and adistal portion of pusher bar 160 is supported between cartridge cover130 and outer channel 132 of channel assembly 108.

Referring now to FIGS. 3-6, pusher bar 160 includes a lower wall 160 aand first and second side walls 160 b, 160 c extending from the lowerwall 160 a. Lower wall 160 a and side walls 160 b, 160 c together definea channel 160 d extending along at least a portion of the pusher bar 160for at least partial reception of jaw assembly 110, a clip carrier 170,a clip follower 174, a clip spring 176 and a camming plate 180 therein.

Referring now to FIGS. 2B, 2C, and 3, first and second side walls 160 band 160 c each include a pair of proximal windows 166 and 168 at aproximal end 160 f for the reception of hooks 112 b of linkage members112. Proximal windows 166 and 168 include a pivot bar 168 a disposedtherebetween about which the linkage members 112 pivot during actuationof handles 106. Each pivot bar 168 a is received within an opening 112 cof the hook 112 b of one of the linkage members 112 to pivotably securethe linkage member 112 to the pusher bar 160.

Referring again to FIGS. 3-6, first and second side walls 160 b, 160 ceach include a distally oriented flexible tab 162 at a distal portion160 e and a distal window 164 which are proximal of the flexible tab162. It is contemplated that distal windows 164 may alternatively bedisposed distal of flexible tabs 162.

Pusher bar 160 further includes a distal end 160 g extending distally ofdistal portion 160 e defining a pusher 160 h configured and adapted toselectively engage/move a distal-most clip “C1” of a stack of clips “C”stored in surgical clip applier 100. In an embodiment, distal end 160 gof pusher bar 160 includes side walls 160 i and 160 j extending fromlower wall 160 a and defining a channel 160 k for the reception of adistal portion of a clip carrier 170. In some embodiments, the sidewalls 160 i and 160 j extend a first height from lower wall 160 a, andthe side walls 160 b and 160 c extend a second height from lower wall160 a. In some embodiments, the first height of side walls 160 i and 160j is less than the second height of side walls 160 b and 160 c.

With reference to FIG. 3, clip applier 100 further includes a clipcarrier 170 disposed within channel assembly 108 and within the channel160 d of pusher bar 160. Clip carrier 170 is a generally box-likestructure having an upper wall 170 a, a pair of side walls 170 b and alower wall 170 c defining a channel 170 d therethrough.

A stack of surgical clips “C” is loaded and/or retained within channel170 d of clip carrier 170 in a manner so as to slide therewithin and/ortherealong. The clips of the plurality of surgical clips “C” arearranged in tip-to-tail fashion within channel 170 d. Clip carrier 170further includes a tab 170 e at a distal end of channel 170 d formaintaining the distal most clip “C1” in place. Clip carrier 170 furtherincludes a fin 170 f extending from a top surface thereof for engagingcartridge cover 130 to inhibit longitudinal movement of clip carrier 170relative to cartridge cover 130. Clip carrier 170 further includes a tab170 g for engaging an opening 176 b of clip spring 176.

With further reference to FIG. 3, clip applier 100 further includes aclip follower 174 slidably disposed within channel 170 d of clip carrier170. As will be discussed in greater detail below, clip follower 174 ispositioned behind the stack of surgical clips “C” and is provided tourge the stack of clips “C” forward during an actuation of clip applier100. Clip follower 174 is biased distally against the stack of clips “C”by a clip spring 176. Spring 176 may take the form of a constant forcespring or other comparable biasing element. A distal end 176 a of clipspring 176 is fixedly attached or secured to clip carrier 170 byinsertion of tab 170 g of clip carrier 170 into opening 176 b of clipspring 176. Clip spring 176 may be fixedly attached to clip carrier 170or any other fixed surface of clip applier 100 and may be fixedlyattached in any manner including, for example, one or more screws,fasteners and the like, through the use of glues, or other adhesives, orthrough the use of plastic or radiofrequency welding. A proximal portion176 c of clip spring 176 is wound around a spool 176 d secured against aproximal end 174 a of clip follower 174. In an embodiment, clip follower174 includes a flange 174 b at the proximal end 174 a for engaging spool176 c. Spool 176 c is biased against flange 174 b by clip spring 176 tobias clip follower 174 against the stack of clips “C”.

During actuation of clip applier 100, as clips “C” are used and thenumber of clips “C” remaining in clip carrier 170 is reduced, withdistal end 176 a of spring 176 fixedly secured in place, spring 176winds-up around spool 176 c to urge clip follower 174 distally againstthe stack of clips “C” and bias or move the stack of clips “C” withinclip carrier 170.

As can be seen in FIGS. 1 and 3, jaw assembly 110 includes a pair ofjaws 120 mounted on or at a distal end of channel assembly 108 andactuatable by handles 106 of handle assembly 102. Jaws 120 are formed ofa suitable biocompatible material such as, for example, stainless steelor titanium.

Jaws 120 are mounted in a distal end of housing 108 such that jaws 120are longitudinally stationary relative to outer channel 132. As seen inFIGS. 1, 2B-2C, and 3, jaws 120 define a channel 120 a therebetween forreceipt of a surgical clip “C” therein. Each jaw 120 further includes arespective camming pin 120 b, 120 c projecting therefrom.

As can be seen in FIGS. 3, 5 and 6, jaw assembly 110 further includes acamming plate 180 disposed within housing 108. Camming plate 180 isslidably received within channel 160 a of pusher bar 160 and includes adistal end 180 a having first and second camming slots 180 b, 180 c thatslidably receive camming pins 120 b, 120 c of jaws 120, respectively.Camming plate 180 is configured to actuate the jaws 120 upon actuationof handles 106.

During actuation of clip applier 100, as camming plate 180 movesproximally, camming pins 120 b, 120 c of jaws 120 travel along cammingslots 180 b, 180 c of camming plate 180 to effectuate closure of thejaws 120 and to form the distal most clip “C1” located or loaded betweenthe jaws 120.

Camming plate 180 further includes a lost motion section 182 having afirst recessed portion 182 a defining a first shoulder 182 b at a distalend thereof, and a second recessed portion 182 c recessed relative tothe first recess portion 182 a and defining a second shoulder 182 d at adistal end thereof. First and second recessed portions 182 a and 182 care configured and dimensioned to slidably receive flexible tabs 162 ofpusher bar 160 therein during actuation of clip applier 100. Flexibletabs 162 of pusher 160 are distally oriented and inwardly biased suchthat when pusher bar 160 and camming plate 180 are in a proximal mostposition (FIG. 9), flexible tabs 162 are biased against second recessedportion 182 c, proximal of or abutting second shoulder 182 d thereof. Inthis manner, as pusher bar 160 moves distally, flexible tabs 162 engageagainst second shoulder 182 d and drive camming plate 180 distally.

Camming plate 180 further includes a proximal flange 180 e at a proximalend 180 f thereof. Proximal flange 180 e is slidably received withinwindows 164 of pusher bar 160. During actuation of clip applier 100, aspusher bar 160 is moved proximally, proximal flange 180 e of cammingplate 180 engages a distal end 164 a of each window 164 to also movecamming plate 180 proximally.

Referring now to FIGS. 3-6, cartridge cover 130 further includes firstrecessed portions 130 a, and second recessed portions 130 b recessedrelative to the first recessed portions 130 a. Between the first andsecond recessed portions 130 a, 130 b are camming surfaces 130 c whichare configured to engage against the flexible tabs 162 of pusher bar 160during distal movement of pusher bar 160 to urge flexible tabs 162 outof second recessed portion 182 c of camming plate 180 and into firstrecessed portion 182 a of camming plate 180 to allow the pusher bar 160to advance distally relative to camming plate 180 to thereby positionthe distal most clip “C1” between the jaws 120. Thus, when distal ends162 a of flexible tabs 162 are engaged against camming surfaces 130 cand slide along camming surfaces 130 c, flexible tabs 162 are disengagedfrom second shoulders 182 d of camming plate 180.

Surgical clip applier 100 may include a lockout mechanism (not shown)disposed in channel assembly 108. The lockout mechanism may be actuatedby clip follower 174 when a proximal most or final clip “C3” (FIG. 3) isexpelled from clip applier 100. The lockout mechanism may be urged byclip follower 174 to extend across a path of pusher bar 160, therebypreventing pusher bar 160 from moving proximally and/or distally.Examples of a variety of suitable lockout mechanisms, for use in clipapplier 100, can be found in U.S. Patent Publication No. 2010/0049216,filed on Aug. 13, 2009, entitled “Surgical Clip Applier and Method ofAssembly,” the entirety of which is incorporated herein by reference.

Surgical clip applier 100 may further include a counter mechanism (notshown) supported in at least one of the housing 104 and the channelassembly 108. The counter mechanism may be configured and adapted todisplay a change in the clip applier, e.g., increment or decrement, uponeach actuation of handles 106. An example of a suitable countermechanism, for use in clip applier 100, can be found in U.S. PatentPublication No. 2010/0049216, filed on Aug. 13, 2009, entitled “SurgicalClip Applier and Method of Assembly,” the entirety of which isincorporated herein by reference.

Surgical clip applier 100 may further include a ratchet mechanism (notshown) including a rack having a plurality of teeth and a pawl having atleast one tooth and configured to selectively engage the rack. Theratchet mechanism may be configured to inhibit inadvertent return of thepusher bar 160 before full actuation of the handles 106. An example of asuitable ratchet mechanism, for use in clip applier 100, can be found inU.S. Patent Publication No. 2010/0049216, filed on Aug. 13, 2009,entitled “Surgical Clip Applier and Method of Assembly,” the entirety ofwhich is incorporated herein by reference.

Surgical clip applier 100 may further include a pusher bar biasingmember (not shown) configured to bias pusher bar 160 distally andmaintain the handles 106 in an un-squeezed condition absent an appliedclosing force. An example of a similar biasing member, for use in clipapplier 100, which can provide a compression or tension force againstclip pusher bar to bias clip pusher bar distally can be found in U.S.Patent Publication No. 2010/0049216, filed on Aug. 13, 2009, entitled“Surgical Clip Applier and Method of Assembly,” the entirety of which isincorporated herein by reference.

With reference to FIGS. 2B-2C and 7-10, the operation of the clipapplier 100 is provided. Referring now to FIGS. 2B and 7, prior to anyinitial squeezing of handles 106 of clip applier 100, in an initial ororiginal position, with a first of clips “C” loaded into the jaws 120,the pusher bar 160 and camming plate 180 are each located in adistal-most position with flexible tabs 162 of pusher bar 160 disposedin first recessed portion 182 a of camming plate 180 and abutting orproximate to first shoulder 182 b thereof. With reference to FIG. 6, inthe initial or original position, proximal flange 180 e of camming plate180 is located at the proximal end of window 164 of pusher bar 160.

Referring now to FIGS. 2B, 8 and 9, the operation associated with aninitial squeezing of handles 106 of clip applier 100 will be described.As illustrated in FIG. 2C, as handles 106 are squeezed an initialamount, link members 112 push pusher bar 160 proximally.

As illustrated in FIGS. 8 and 9, during the initial squeezing of handles106, as pusher bar 160 translates proximally, flexible tabs 162 slideproximally along first recessed portion 182 a of camming member 180 andfirst recessed portion 130 a of cartridge cover 130 until flexible tabs162 reach camming surfaces 130 c of cartridge cover 130. As flexibletabs 162 slide over camming surfaces 130 c, flexible tabs 162 engageagainst second recessed portion 182 c of camming member 180 proximal ofsecond shoulder 182 d and second recessed portion 130 b of cartridgecover 130 due to the inward biasing of flexible tabs 162.

As pusher bar 160 continues to translate proximally, proximal flange 180e of camming plate 180 engages distal end 164 a of window 164 of pusherbar 160 thereby causing camming plate 180 to also translate proximally.

Referring now to FIGS. 9 and 10, the operation associated with a furthercontinued squeezing of handles 106 of clip applier 100 will bedescribed. As handles 106 are squeezed a subsequent amount, pusher bar160 continues to translate proximally. As pusher bar 160 translatesproximally, camming plate 180 translates proximally due to theengagement of flange 180 e thereof with the distal end 164 a of eachwindow 164, and camming pins 120 b and 120 c of jaw assembly 110 travelalong camming slots 180 b and 180 c of camming plate 180 to actuate thejaws 120 from an open configuration with camming pins 120 b and 120 cspace apart (FIG. 7) to a closed configuration with camming pins 120 band 120 c approximated toward one another (FIG. 10) to form a surgicalclip “C” positioned within the jaws 120.

Referring now to FIG. 10, the state of clip applier 100 with handles 106in the fully squeezed position will now be described. As illustrated inFIG. 10, with handles 106 in the fully squeezed position, pusher bar 160and camming plate 180 are at proximal most positions with camming pins120 b and 120 c at the distal end of camming slots 180 b and 180 c,respectively, with jaws 120 approximated together in the closedconfiguration to form a clip “C” disposed between jaws 120 about tissueor a vessel. Flexible tabs 162 of pusher bar 160 are biased againstsecond recessed portion 180 c of camming plate 180 and second recessedportion 130 b of cartridge cover 130 with the distal end 162 a offlexible tabs 162 located proximal of second shoulder 182 d and cammingsurfaces 130 c. In the fully squeezed position, proximal flange 180 e ofcamming plate 180 is located at a distal end 164 a of distal window 164a.

Once the distal most clip “C1” has been formed about the tissue orvessel, handles 106 are released or un-squeezed. With reference to FIGS.6-10 in reverse order, the operation associated with the releasing ofhandles 106 will now be described.

As illustrated in FIG. 2C, as handles 106 are released an initialamount, link members 112 pull pusher bar 160 distally.

As illustrated in FIGS. 9 and 10, during the initial release of handles106, as pusher bar 160 translates distally, distal ends 162 a offlexible tabs 162 engage against second shoulders 182 d of camming plate180 to also move camming plate 180 distally. As camming plate 180 movesdistally, pins 120 b and 120 c of jaws 120 travel proximally along tocamming slots 180 b and 180 c to begin opening or un-approximating jaws120.

As illustrated in FIGS. 8 and 9, during continued releasing of handles106, as pusher bar 160 and camming plate 180 continue to move distally,camming pins 120 b and 120 c of jaws 120 reach the proximal ends ofcamming slots 180 b and 180 c and the jaws 120 are in an un-approximatedor open configuration and ready to receive the next clip “C”.

During the further releasing of handles 106, as pusher bar 160 movesdistally relative to cartridge cover 130, distal ends 162 a of flexibletabs 162 slide along camming surfaces 130 c of cartridge cover 130 andare flexed outward relative to second recess 182 c of camming plate 180and second recess 130 b of cartridge cover 130 and into first recess 182a of camming plate 180 and first recess 130 a of cartridge cover 130. Inthis manner distal ends 162 a of flexible tabs 162 are disengaged fromsecond shoulder 182 d of camming plate 180.

As illustrated in FIGS. 7 and 8, during a further continued releasing ofhandles 106 pusher bar 160 continues to translate distally with distalends 162 a of flexible tabs 162 sliding along first recess 182 a ofcamming plate 180 and first recess 130 a of cartridge cover 130. Becausedistal ends 162 a of flexible tabs 162 are no longer engaged againstsecond shoulder 182 d of camming plate 180, camming plate 180 is nolonger translated distally by pusher bar 160 and pusher bar 160 isallowed to further translate distally relative to camming plate 180.

During the continued distal translation of pusher bar 160, pusher 160 hengages a new distal most clip “C2” and urges the new distal most clip“C2” between jaws 120. Once the new distal most clip “C2” has been urgedbetween jaws 120, clip follower 174 advances the stack of clips “C” dueto the biasing of clip biasing member 176.

Once handles 106 have been fully released, clip applier 100 has beenreturned to the initial or original position with clip “C2” loadedbetween jaws 120 and pusher bar 160 and camming plate 180 in the distalmost positions. The clip applier 100 is now ready to apply and form clip“C2” to tissue or another vessel in the manner described above for clip“C1”.

It should be understood that the foregoing description is onlyillustrative of the present disclosure. Various alternatives andmodifications can be devised by those skilled in the art withoutdeparting from the disclosure. Accordingly, the present disclosure isintended to embrace all such alternatives, modifications and variances.The embodiments described with reference to the attached drawing figuresare presented only to demonstrate certain examples of the disclosure.Other elements, steps, methods and techniques that are insubstantiallydifferent from those described above and/or in the appended claims arealso intended to be within the scope of the disclosure.

What is claimed is:
 1. A surgical clip applier, comprising: a housing;at least one handle pivotably connected to the housing; a channelassembly extending distally from the housing, the channel assemblyincluding a camming surface; a clip carrier disposed within the channelassembly and defining a channel therein; a plurality of clips slidablydisposed within the channel of the clip carrier; a jaw assemblyincluding a pair of jaws extending from an end of the channel assembly,opposite the housing, the jaw assembly configured to accommodate a cliptherein and being operable to effect formation of the clip in responseto movement of the at least one handle; a clip pusher bar slidablysupported within at least one of the housing and the channel assembly,the clip pusher bar having a first end operatively connected to the atleast one handle and at least one flexible tab; and a camming plateslidably supported within the channel assembly and configured toeffectuate closure of the pair of jaws, the camming plate including alost motion portion, the at least one flexible tab of the clip pusherbar being configured to: engage the lost motion portion during aninitial movement of the clip pusher bar to cause the camming plate tomove with the clip pusher bar; and disengage from the lost motionportion during a subsequent movement of the clip pusher bar to allow theclip pusher bar to move relative to the camming plate, wherein thecamming surface of the channel assembly is configured to disengage theat least one flexible tab from the lost motion portion.
 2. The surgicalclip applier according to claim 1, wherein the lost motion portion ofthe camming plate includes a shoulder, the at least one flexible tabconfigured to engage the shoulder during the initial movement of theclip pusher bar and to disengage from the shoulder during the subsequentmovement of the clip pusher bar.
 3. The surgical clip applier accordingto claim 2, wherein the lost motion portion includes a first recess anda second recess, the at least one flexible tab being slidably disposedwithin the second recess during the initial movement of the clip pusherbar and being slidably disposed within the first recess during thesubsequent movement of the clip pusher bar.
 4. The surgical clip applieraccording to claim 3, wherein the shoulder is located at a distal end ofthe second recess of the lost motion portion.
 5. The surgical clipapplier according to claim 1, wherein the channel assembly includes afirst recess and a second recess, wherein the camming surface isdisposed between the first and second recesses of the channel assembly,and wherein the at least one flexible tab is configured to: slide alongthe second recess during the initial movement of the clip pusher baruntil the camming surface is reached; cam along the camming surface todisengage the at least one flexible tab from the lost motion portion;and slide along the first recess during the subsequent movement of theclip pusher bar.
 6. The surgical clip applier according to claim 1,wherein the clip pusher bar further includes a second end configured tourge a clip from the plurality of clips to a location between the jaws.7. The surgical clip applier according to claim 6, wherein the clippusher bar is moveable toward the jaw assembly to urge the clip from theplurality of clips to the location between the jaws and moveable awayfrom the jaw assembly to effectuate closure of the pair of jaws.
 8. Thesurgical clip applier according to claim 1, wherein the camming plate ismovable away from the jaw assembly as the at least one handle isactuated in a first direction to effectuate closure of the jaws, thecamming plate being movable toward the jaw assembly as the at least onehandle is actuated in a second direction to effectuate opening of thejaws.
 9. The surgical clip applier according to claim 1, wherein thecamming plate includes at least one camming slot and the jaws include atleast one camming pin received within the at least one camming slot ofthe camming plate.
 10. The surgical clip applier according to claim 9,wherein the camming pin cams along the camming slot to effectuateopening and closure of the jaws during movement of the camming plate.11. The surgical clip applier according to claim 1, wherein the at leastone flexible tab is distally oriented and inwardly biased against thelost motion portion of the camming plate.
 12. The surgical clip applieraccording to claim 1, wherein the camming plate includes a proximalflange and the clip pusher bar includes a distal window, the proximalflange of the camming plate being received within the distal window andengaged with a distal end of the distal window when the clip pusher barmoves proximally to move the camming plate proximally.
 13. The surgicalclip applier according to claim 1, wherein the clip pusher bar includesat least one proximal window configured to receive a link member of theat least one handle to provide the operative connection with the atleast one handle.
 14. A surgical clip applier, comprising: a housing; atleast one handle pivotably connected to the housing; a channel assemblyextending distally from the housing; a clip carrier disposed within thechannel assembly and defining a channel therein; a plurality of clipsslidably disposed within the channel of the clip carrier; a jaw assemblyincluding a pair of jaws extending from an end of the channel assembly,opposite the housing, the jaw assembly configured to accommodate a cliptherein and being operable to effect formation of the clip in responseto movement of the at least one handle; a clip pusher bar slidablysupported within at least one of the housing and the channel assembly,the clip pusher bar having a first end operatively connected to the atleast one handle and at least one flexible tab; and a camming plateslidably supported within the channel assembly and configured toeffectuate closure of the pair of jaws, the camming plate including alost motion portion, wherein the at least one flexible tab is distallyoriented and inwardly biased against the lost motion portion of thecamming plate, the at least one flexible tab of the clip pusher barbeing configured to: engage the lost motion portion during an initialmovement of the clip pusher bar to cause the camming plate to move withthe clip pusher bar; and disengage from the lost motion portion during asubsequent movement of the clip pusher bar to allow the clip pusher barto move relative to the camming plate.
 15. A surgical clip applier,comprising: a housing; at least one handle pivotably connected to thehousing; a channel assembly extending distally from the housing; a clipcarrier disposed within the channel assembly and defining a channeltherein; a plurality of clips slidably disposed within the channel ofthe clip carrier; a jaw assembly including a pair of jaws extending froman end of the channel assembly, opposite the housing, the jaw assemblyconfigured to accommodate a clip therein and being operable to effectformation of the clip in response to movement of the at least onehandle; a clip pusher bar slidably supported within at least one of thehousing and the channel assembly, the clip pusher bar having a first endoperatively connected to the at least one handle and at least oneflexible tab, the clip pusher bar including a distal window; and acamming plate slidably supported within the channel assembly andconfigured to effectuate closure of the pair of jaws, the camming plateincluding a lost motion portion and a proximal flange, the at least oneflexible tab of the clip pusher bar being configured to: engage the lostmotion portion during an initial movement of the clip pusher bar tocause the camming plate to move with the clip pusher bar; and disengagefrom the lost motion portion during a subsequent movement of the clippusher bar to allow the clip pusher bar to move relative to the cammingplate, wherein the proximal flange of the camming plate is configured tobe received within the distal window of the clip pusher and engaged witha distal end of the distal window when the clip pusher bar movesproximally to move the camming plate proximally.